The title of this project is Improving Childhood Immunization Compliance Using Electronic Health Records. This application addresses broad Challenge Area (05) Comparative Effectiveness Research and specific Challenge Topic, 05-LM-103: Improving Compliance of School Children with Immunization Schedules. While immunizations are routinely cited as the most valuable pediatric preventive service, fewer than half of children receive all recommended immunizations on time. In addition, the National Healthcare Disparities Report consistently demonstrates substantial racial, ethnic, and socioeconomic disparities in childhood immunization delivery. The overall goal of the proposed research is to improve the entire spectrum of school-aged childhood immunization rates among a predominantly African American, inner city population, utilizing and comparing 2 interventions: 1. an automated Electronic Health Record-derived provider-specific performance feedback report, and 2. automated Electronic Health Record-derived trigger alerts when patients in need of immunizations present to clinic. Successful completion of this project will inform the National Institutes of Health, providers, patients, payers, policymakers and the public how to maximize the impact of electronic health records to improve immunization rates among school-aged children. Results of this study will add important new knowledge to the field regarding whether and how electronic health records can be used to improve immunization rates among school-aged children. These findings can be applied to narrow the gap between evidence and practice in terms of completion rates for school-aged childhood immunizations. The overall goal of the proposed research is to improve the entire spectrum of school-aged childhood immunization rates among a predominantly African American, inner city population, utilizing and comparing 2 interventions: 1. an automated Electronic Health Record-derived provider-specific performance feedback report, and 2. automated Electronic Health Record-derived trigger alerts when patients in need of immunizations present to clinic. Successful completion of this project will inform the National Institutes of Health, providers, patients, payers, policymakers and the public how to maximize the impact of electronic health records to improve immunization rates among school-aged children. .